THE DIFFERENCE BETWEEN FAIR AND FAIRLY

I travel all the time but have not paid the $100 for the TSA pre-check. However, I get selected for this line in LGA more often than not. I think that they (Delta) know the frequency that I travel and do not consider me a risk. I will tell you that it ticks off the people on my team that have paid for the service.

This was a recent Facebook post from one who was randomly chosen to use the TSA pre-check line. TSA does this to encourage more to be pre-screened. It cost me $84 to get mine, and I had to drive to Roseburg to be fingerprinted, but the few times I fly, I don’t wait in line. I am at an age when convenience is worth a lot, even if I can’t attach a dollar value to it.

“It ticks off the people on my team that have paid for the service.” In other words, somebody got something for nothing, They had to pay for it, IT IS NOT FAIR, IT IS WRONG, AND IT MUST BE CHANGED.

Fairness is an American obsession. Many want to end Food Stamps, now SNAP, Supplemental Nutrition Assistance Program, because a few have abused it to buy things they shouldn’t have. Food Stamps is one of the least abused, most useful of all federal programs. Still, any unfairness bothers people. In Kentucky, able-bodied adults between 18 and 50 with no dependents must work, volunteer, or take classes for 20 hours a week for SNAP. Heaven forbid somebody get something for nothing. Many can’t find jobs, and I know first hand the difficulty to find volunteer opportunities. If we want “must work programs” let’s have mandatory national service for the young and able-bodied on welfare with an organized list of thousands of jobs, thousands of supervisors, so that we can fix infrastructure and support the three gifts America gave the world: liberty (military service), the national parks (build trails, fix the backlog of jobs), and public education (help in the schools). Then let’s pay them by giving them a reasonable stipend followed by four years of education in a field of their choice after completion of their duty. Such work gives people dignity, and I can’t attach a dollar value to dignity, either.

Because somebody cheats on welfare, many want to disband it. One should pull himself up by his own bootstraps, by golly. This is difficult if one doesn’t have shoes, let alone boots. If we tried to enhance family planning, rather than trying to destroy it, we would have fewer children, less poverty, and require fewer jobs. Freeloaders are employers who come to a city lured by tax breaks, not single women with children on welfare. Every corporation that skirts IRS laws is a freeloader.

In college, I discovered for the first time in my life that hard work didn’t bring success and good grades. It wasn’t fair, but life isn’t. When asked whether it was fair to call Reservists up for duty in Vietnam, JFK replied, “There is always inequity in life. Some men are killed in a war and some men are wounded, and some men never leave the country, and some men are stationed in the Antarctic and some are stationed in San Francisco. It’s very hard in military or in personal life to assure complete equality. Life is unfair.”

Want to know something that wasn’t fair? Read Paul Kalanithi’s “My Last Day as a Surgeon” or “How long do I have left?” He was, the past tense a sad way to refer to a remarkable human being, a neurosurgical resident, diagnosed during his training as having Stage IV non-small cell lung cancer. He died two years later at 37. As a resident, he was a skilled communicator and physician. He learned in his last two years of life to enjoy the simple things as realizing his reassurance of a patient mattered. He was a physician-scientist who could have been a writer, too. It wasn’t fair that he died so young. He quoted his chances of getting his disease: 0.00012%

As a physician, a lot of my stress was seeing people who had medical problems that weren’t fair. I saw the 55 year-old at 2 a.m. with a sudden onset of a Grade V (the worst) subarachnoid hemorrhage, who was going to die. Not fair. I saw a colleague develop a glioblastoma multiforme, which killed him at age 52. Not fair. Or the 41 year-old man who in the ED at midnight, with a big stroke, whose wife said, “He’s going to die,” and I remained silent, because I knew she was right. Not fair. The 25 year-old woman devastated by MS. Not fair. The 28 year-old who broke his tibia, who coded one night at 3 a.m. He didn’t make it. I can still see the ugly, huge pulmonary embolus at his autopsy. A gifted classmate, hiking by a Colorado river, falling, hitting his head and drowning. He was 27. Not fair. Notice that four of these were sudden.

This is life, or maybe death. Bad things happen. Some we can prevent, and some we haven’t a clue how to prevent. I try to think that I must make each day count in some way, because we don’t have forever, and time is passing. Atrial fibrillation was my game changer. My probability of having a stroke has significantly increased. Not fair that I inherited some bad genes, but biology doesn’t really care how I feel. It just is. I’m moving on. The clock is really ticking now.

One question we must address as a society is how much unfairness is…for lack of a better word…fair. The other is how to treat people fairly.

The tax code is unfair and could be changed. It is not a malignancy. I don’t think it is either fair or appropriate to pay women less who do the same work as men. I don’t think it is fair for a child to die of a preventable disease because the parents didn’t believe in vaccination. I don’t think it is fair that people should go bankrupt because they had a medical condition that nobody could have foreseen.

We aren’t born equal, we don’t have equal opportunities and life will never be fair. We can, however, treat people fairly who end up on the wrong side of the luck scale. Any of us could be one of them.